肠结核与克罗恩病肠黏膜中胶原纤维及相关蛋白的表达差异  

The efficacy of collagen fibers and fibrosis related proteins for discriminating intestinal tuberculosis from crohn＇ s diseas

作　　者：蓝亚珊 毛华[1] 黄丽韫[1] 卢敏[1] 金少琴[1] 厉周[2] 

机构地区：[1]南方医科大学珠江医院消化内科,广州510280 [2]南方医科大学珠江医院普通外科,广州510280

出　　处：《中华实验外科杂志》2016年第6期1653-1655,共3页Chinese Journal of Experimental Surgery

摘　　要：目的分析肠结核（ITB）与克罗恩病（CD）肠镜活检标本胶原纤维及相关蛋白转化生长因子-β（TGF-β）、波形蛋白（Vimentin）表达差异，探讨其在鉴别诊断的意义。方法收集在我院确诊为ITB、CD患者及健康体检者的肠镜活检标本，分别行Masson染色、免疫荧光双染色、免疫组织化学染色，使用图像分析软件计算总胶原、Ⅰ、Ⅲ型胶原及TGF-β、Vimentin的表达强度，并采用受试者工作（ROC）曲线评价这些指标对鉴别两病的价值。结果总胶原纤维量、Ⅰ型及Ⅲ型胶原纤维量、TGF-β、Vimentin在3组间表达差异有统计学意义（P〈0．05），ITB组总胶原纤维量、Ⅰ型及Ⅲ型胶原纤维量显著高于CD组（P〈0．05），CD组Vimen曲的表达显著高于ITB组（P〈0．05），TGF-β表达在ITB组与CD组比较差异无统计学意义（P〉0．05）。ROC曲线分析显示，总胶原纤维量、Ⅰ型及Ⅲ型胶原纤维量对鉴别两病有一定价值，其对ITB与CD鉴别诊断的灵敏度分别为80．0％、86．7％、73．3％，特异度分别为78．9％、52．6％、73．7％。而Vimentin表达水平对鉴别两病意义不大。结论总胶原纤维、Ⅰ、Ⅲ型胶原纤维量对鉴别ITB与CD有一定价值。Objective We compared the differences of collagen fibers and fibrosis related proteins in patients with intestinal tuberculosis （ITB） and Crohn＇ s disease （CD） in order to find out a new clue to discriminate the two diseases. Methods Colonoseopic biopsies from healthy controls and patients diagnosed as ITB and CD in Zhujiang hospital were collected. The content of total collagen, type Ⅰ and Ⅲ collagen were evaluated by masson＇ s trichrome staining and double label immunofluoreseence staining. Immunohistochem- istry was used to detected the expression level of transforming growth factor - β （TGF - β） and vimentin. Receiver operator characteristic curve （ROC curve） was established to evaluate the value of those indicators for discriminating ITB from CD. Results It was found that the content of total collagen, type I collagen, type m collagen were significantly higher in patients with ITB than those of CD （ P 〈 0. 05 ）, while vimentin was significantly higher in CD group than ITB group （P 〈 0. 05）, and expression level of TGF - β was of no significance between CD group and ITB group （P 〉 0. 05）. ROC curve analysis showed the content of total collagen, type I collagen, type m collagen were valuable in discriminating ITB from CD, whose sensitivity and specificity are 80. 0% and 78. 9%, 86. 7% and 52. 6%, 73. 3% and 73.7%, respectively. However, vimentin showed no value in discriminating the two disease. Conclusion The content of total collagen, type Ⅰ collagen, type Ⅲ collagen were valuable in discriminating ITB from CD.

关 键 词：肠结核 克罗恩病 纤维化 转化生长因子-Β 波形蛋白 

分 类 号：R574.62[医药卫生—消化系统] R524[医药卫生—内科学]